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Acne During Pregnancy

Sometimes acne improves during pregnancy. Sometimes it can worsen. However, there are limited options for treatment of acne during pregnancy, and some of these options are prescription-only medicines.

Main Treatments

Skin Care

Add ons

For new zits, use pimple spot treatment
For flat red or pink blemishes, use a blemish spot treatment
For any raised scars, use scar spot treatment

What to Avoid

Benzoyl peroxide
Salicylic acid
Retinol and retinoids
Tetracycline, doxycycline, and minocycline
Birth control pills

Severe Acne During Pregnancy

For patients who are pregnant or looking to conceive with severe acne refractory to topical therapy, azithromycin is a good oral antibiotic. A typical dose would be 250 mg three times per week (Monday, Wednesday, and Friday). Doxycycline, minocycline, tetracycline, sulfamethoxazole/trimethoprim, and isotretinoin are not safe choices, and other antibiotics such as erythromycin base or clindamycin can be used. However, erythromycin isn’t very effective for acne and comes with diarrhea as an adverse reaction. Because of the potential for antibiotic-induced diarrhea due to the bacteria Clostridium difficile, I do not recommend the use of the oral antibiotic clindamycin for acne; the risks of its use outweigh the benefits of its use.